Patient reported outcomes (PROs) collection modalities among patients diagnosed with cancer: Online vs in-person.
Authors: Eric Adjei Boakye, Carl Wilson, Theresa Zatirka, Samantha Tam, Nada Al-Antary, Mrudula Nair, Laila Poisson, Kelly Hirko, Michael Ryan, Steven S. Chang, Benjamin Movsas
Journal: Journal of Clinical Oncology (2023)

6612 Background: Patient reported outcomes (PRO) can be valuable clinical tools to embed the voice of patients into the clinical assessment. PROs provide important metrics to guide treatment decision making, improve quality of life, reduce acute care, and extend survival in cancer patients. Different modalities for collecting patient reported outcome measures (PROMs) exist (e.g., electronic, paper, telephone); yet little is known about factors associated with PROMs completion modality. More information on PROMs completion modality may determine addressable barriers. We sought to determine whether patients’ sociodemographic and clinical factors differed by completion modality. Methods: Beginning in 2021 all patients diagnosed with cancer who had a visit with an oncologic provider at a tertiary cancer center were assigned the National Institute of Health’s computer adaptive tests Patient-Reported Outcomes Measurement Information System (PROMIS) instruments in pain interference, physical function, fatigue, and depression through the MyChart patient portal 7 days prior to the visit. If this was not completed at the time of the visit, it was available for completion on a tablet during check-in. The outcome variable was completion modality defined as the method a patient used to complete their PROMs (MyChart vs. In-Person). Multivariable logistic regression model was used to estimate the association between patients’ sociodemographic and clinical factors (age, sex, race/ethnicity, marital status, insurance type, stage, provider specialty) and completion modality. Results: A total of 2915 patients completed PROMs, of which 54% completed using MyChart and 46% completed in-person. The average age of patients was 59.6 (SD=12.4) years, most were females (63.1%), White (69.4%) and married (59.2%). Compared to male patients, females were less likely to complete PROMs in-person (aOR=0.80, 0.67–0.95). However, patients were more likely to complete PROMs in-person if they were of Black race (aOR=1.85, 1.52–2.24) or Other race (aOR=1.48, 1.12–1.96) vs. White; single (aOR=1.30, 1.05–1.62) vs. married; or have Medicaid/other insurance (aOR=1.52, 1.15–2.01) vs. private insurance. Patients who had visits with a radiation oncology provider (aOR=1.50, 1.20–1.86) or surgical oncology provider (aOR=1.32, 1.07–1.62) were more likely to complete PROMs in-person compared to those who had visits with a medical oncology provider. Conclusions: Almost half of the patients completed PROMs in-person during check-in, which was unexpected in the context of trends toward mobile-based patient engagement. Patients in underserved populations were the most likely to complete PROMs in-person. Although offering PROMs remotely may be more efficient and allow monitoring between visits, offering an in-person option helps to capture PROs from underserved populations.